Proscar Reduction of Prostate

April 12, psa of 4. April 13, 4.35, November 13, 4.7. Age 65. Biopsy revealed 3 of 12 cores involved, max 15%, Gleason of 6 (3+3).

During biopsy Dr had to have a tech come in to enlarge the field of view of the ultasound. He estimated my prostate at 137 grams. Due to heart history he is hesitant to recommend robotic surgery with its 4 hour duration. He recommends AS with consideration of future open surgery or radiation. Either way he is recommending a turp and has placed me on Proscar.

Anybody have experience with proscar? How much reduction can I actually expect with it?

Welcome ShinytopPC and sorry about your Dx. That is one whopper of a prostate! It seems to be interfering with your urination, which is why your Uro is recommending a TURP. A TURP now does complicate some of your treatment options later. Nerve-sparing surgery may be more difficult, and seeds will be impossible. But that still leaves you with SBRT, HDR brachytherapy, IMRT or proton.

There is a long-running thread on this site about the "Gat Goren method," that you may be interested to learn about (put it in the search bar). Laser TURP is increasingly popular over surgical TURP.

I have little to add over JNF's excellent response, other that Proscar has been known to shrink tumors in men who are on AS. As it shrinks your prostate, it will improve the diagnostic ability of the PSA test and make any cancer easier to find.

Dear Shiny

Didn't you have any symptoms of BPH with such a large prostate? As others have said, gleason 6 is really good news and you should be a candidate for AS. I took proscar (finasteride generic) for ten years and my prostate was only 33 gm when I was dxed with gl9 PCa.

I have no idea how fast it shrunk and I didn't care; my primary interest was relief from BPH symptoms, and it worked, along with tamsulosin. Just be aware that your PSA needs to be adjusted to about double the actual reading as proscar cuts PSA about in half also.
Bob
__________________________________________________________________________________
DOB January 1944
1981: prostatitis
2000-2013 BPH treated with finasteride & tamsulosin; low T treated with androgel
PSA History:
Pre 2009 0.4-.6
11/2011 2.2
8/2012 2.7
2/2103 5.5
4/2013 6.1
5/2013 6.6
11/2013 0.1
1/2014 0.2

6/2013 Bx:PCa Gleason 4+4=8 (Bostwick), 4+5= 9(Johns Hopkins), 2/6 cores, 10%, 40%, DRE neg. (Stage PT1c)
7/2013 bone scan and pelvic MRI negative
9/7/13 open RRP, Johns Hopkins, Ted Schaeffer MD PhD.
9/9/13 Pathology: 33G, both nerves spared, SVI, EPE and 4mm pos. margin at base (Gl7), Stage PT3bN0M0)
9/20/13 Foley and staples removed
Continence: one pad per day for 13 weeks, now none. ED pre and post op.
Watchful waiting until next PSA May 1, 2014

Then what do you need a TURP for? The Proscar will eventually shrink your prostate without having to cut it out.